Multimedia
 | Media file 1: Pathophysiology of gynecomastia. Estradiol is the growth hormone of the breast, and an excess of estradiol leads to the proliferation of breast tissue. Under normal circumstances, most estradiol in men is derived from the peripheral conversion of testosterone and adrenal estrone. The basic mechanism of endocrine-related gynecomastia is a decrease in androgen production, an absolute increase in estrogen production, and an increased availability of estrogen precursors for peripheral conversion to estradiol. |
 | Media file 2: Flow chart of the workup to determine the etiology of gynecomastia. |
 | Media file 3: The Webster intra-areolar incision is placed in the inferior hemisphere. |
 | Media file 4: The Webster intra-areolar incision may be enlarged by lateral and medial extensions. |
 | Media file 5: The transverse nipple-areola incision. |
 | Media file 6: The triple-V incision offers increased exposure. This approach is rarely used today. |
 | Media file 7: The most common technique for skin resection and nipple transposition is the Letterman technique. |
 | Media file 8: In massive gynecomastia, an en bloc resection of excessive skin and breast tissue and free nipple grafting can be performed using an elliptical incision with a nipple-areola graft. |
 | Media file 9: Preoperative anteroposterior view of a patient with idiopathic gynecomastia. |
 | Media file 10: Preoperative lateral view of a patient with gynecomastia. |
 | Media file 11: Postoperative view of patient after surgical glandular excision and combined ultrasonic-assisted liposuction (UAL) and power-assisted liposuction (PAL). |
 | Media file 12: Postoperative view of above patient. Note that while the glandular and fatty tissue have been removed, the nipples remain in the preoperative position relative to each other. Also note the significant skin retraction postoperatively. |
More on Gynecomastia |
| Overview: Gynecomastia |
| Workup: Gynecomastia |
| Treatment: Gynecomastia |
| Follow-up: Gynecomastia |
 Multimedia: Gynecomastia |
| References |
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Further Reading
Keywords
male breast enlargement, female-like breasts, feminization, male feminization, mastectomy, liposuction-assisted mastectomy, reduction mammaplasty, male breast lesion, male breast abnormality, male breast anomaly, feminized male breast, breast mass, male breast mass, congenital anorchia, Klinefelter syndrome, Klinefelter's syndrome, testicular feminization, hermaphroditism, hermaphrodite, adrenal carcinoma, adrenal cancer, liver disorder, hepatic disorder, liver disease, hepatic disease, malnutrition, testosterone deficiency, gynecomastia, ideopathic gynecomastia, surgical gynecomastia, glandular gynecomastia
